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Monoclonal antibodies Flashcards

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1
Q

What does secukinumab target?

A

IL-17 A

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2
Q

Side effect of seckinumab

A

Infection (TB)

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3
Q

Target of ustekinumab?

A

Anti-IL12 and anti-IL-23 (binds to p40 subunit)

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4
Q

What diseases can ustekinumab be used for?

A

Psoriasis, psoriatic arthritis

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5
Q

Denosumab target and use?

A

Anti-RANK ligand on osteoclasts. Used for osteporosis

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6
Q

Side effect of denosumab?

A

Avascular necorosis of the jaw, injection site reactions

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7
Q

Tocilizumab target of action?

A

Anti-IL6, reduce macrophage, T and B cell, neutrophil activation

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8
Q

What does secukinumab treat?

A

Psoriasis, psoriatic arhtirits, ankylosing spondylitis

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9
Q

Use of tocilizumab?

A

Treats RA and castleman’s disease

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10
Q

Target and use of sarilumab?

A

Anti-IL-6, reduce macrophage T and B cells.
Neutrophil activation. Treats RA

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11
Q

What is the target for guselkumab?

A

Anti-IL-23 (p19 alpha subunit)

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12
Q

Diseases treated by guselkumab?

A

Psoriasis, psoriatic arthritis

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13
Q

What is IL-1 blockade used to treat?

A

Familial mediterranean fever, gout, adult onset Still’s disease

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14
Q

What does IL-4/5/13 blockade treat?

A

Eczema, asthma, eosiniophilic asthma

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15
Q

What does Etanercept target?

A

TNF alpha/beta receptor. p75 IgG fusion protein, inhibits both cytokines

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16
Q

What does Etanercept treat?

A

RA, AS, psoriasis, psoriatic arthritis

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17
Q

What disease do certolizumab/golimumab treat?

A

IBD, familial mediterranean fever

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18
Q

What does infliximab target?

A

TNF-alpha

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19
Q

In which conditions can infliximab be used?

A

RA, AS, psoriasis, psoriatic arthritis, IBD, familial mediterranean fever

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20
Q

what malignancy can infliximab cause?

A

Lymphoma

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21
Q

List some TNF -alpha inhibitors

A

Infliximab, adalimumab, golilumab, certolizumab

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22
Q

What is the mode of action of basiliximab?

A

Anti-CD25 (alpha chain of Il-2 receptor). Inhibits T cell proliferation

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23
Q

Which monoclonal antibody targets CD25?

A

Basiliximab

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24
Q

Use of basiliximab?

A

Allograft rejection (prophylaxis)

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25
Describe abatercept
Anti-CTLA4-Ig fusion protein, reduces co-stimulation of T cells via CD28
26
What condition can abatercept be given to treat?
Rheumatoid arthritis
27
Describe the action of rituximab
Anti-CD20, depletes mature B cells
28
What conditions is rituximab treatment utilised in?
Lymphoma, RA, SLE
29
Mode of action of Natalizumab
Anti-alpha-4 beta-1 integrin. Inhibits T cell migration
30
Diseases treated by natalizumab
Relapsing, remitting MS, Crohn's disease
31
Name an important side effect of natalizumab
JC virus reactivation
32
Which monoclonal antibody is useful in treating IBD?
Vedolizumab
33
What is the mode of action of vedolizumab?
Anti-alpha-4-beta 7 integrin. Inhibits cell migration
34
Describe the mode of action of Muromonab-CD3
Blocks CD3 on T cells, mouse monoclonal antibody (OKT3)
35
Use of muromonab-CD3 and side effects
Active allograft transplantation rejection. SEs are fever and leucopenia
36
Antibody in CREST syndrome?
Anti-centromere
37
Treatment for ankylosing spondylitis?
etanercept
38
Treatment for resistant psoriasis?
Etanercept
39
3. Chronic granulomatous disease treatment?
IFN gamma
40
C. What immune cells detects antigen in the periphery and moves to lymph node
Dendritic cells
41
C. What immune cells detects antigen in the periphery and moves to lymph node
Dendritic cells
42
D. What immune cell detects MHC1 and kills virus infected/cancer cells. Is inhibited by MHC I
NK cells
43
3. 72 yr lady with stiff limb girdles (Polymyositis) (which antibody is seen)
anti-Jo1
44
2. SLE with recurrent clotting
Anti-cardiolipin antibodies
45
4. Bloated after drinking milk but not IgE mediated ?
Lactose intolerance
46
1. A teenage girl who when she goes cross country running gets an erythematous rash on her legs. It is well controlled by antihistamines
cold urticaria
47
1. Woman presents with aches all over and joint stiffness?
Anti-Jo1
48
60 year old lady with recurrent chest infections now has reduced total serum protein and has autoimmune thrombocytopenia
CVID
49
2. A 12 year old boy has recurrent chest infections and has an ear infection. He doesn’t have any B Cells
Bruton’s Agammaglobulinaemia
50
4. A Girl is found to have no CD4 cells, but CD8 cells and B cells are present
BLS 2
51
5. A boy’s father has TB. The same boy develops a mycobacterium infection, following their BCG?
Interferon gamma deficiency
52
1. Young girl with normal B cells, normal CD8+ but absence of CD4+
BLS 2
53
2. Young boy with normal B cell numbers and absence of CD8+ and CD4+
X-linked SCID
54
4. Lady with spinal fracture due to severe TB
Interferon gamma receptor deficiency
55
5. Patient with recurrent pneumococcal infections and meningitis
Complement deficiency
56
2. Used to treat malignant melanoma, involved in T cell checkpoints
Ipilimumab or Nivolumab
57
4. Used to prevent transplant rejection, by blocking T cell activation and
Tacrolimus or Cyclosporin
58
5. Used to treat severe ankylosing spondylitis not controlled by NSAIDs
Etanercept
59
1. In its immature form it is specialised to phagocytose pathogens, and in its mature form it is specialised to present to other cells
Dendritic cells
60
1. Mentioned FAS pathway
ALPS
61
3. Nod2/CARD15
Crohn's disease
62
2. Mentioned MEFV gene, periodic abdominal pain and ascites
Familial mediterranean fever
63
2. Hypertensive and diabetic, with angioedema
Drug reaction to ACEi
64
4. Woman with flushed face, problems breathing that has happened multiple times with enlarged liver
hereditary angioedema
65
5. Mechanism behind cellular rejection
T cell mediated
66
4. Mechanism behind antibody mediated rejection
B cell mediated
67
3. Mechanism behind GVHD
Donor WBCs attack host tissue
68
Causes progressive multifocal leukoencephalopathy
JC virus
69
2. What type of hypersensitivity (Gel and Coombs classification) is myasthenia gravis and what cell?
Type 2
70
3. IPEX affects what type of immune cell?
T reg
71
4. 16 year old girl has pleuritic chest pain, joint pain, positive ANA and Anti-Sm, no liver enzyme derangement, raised ESR
SLE
72
5. Chimeric antigen receptor T-cell therapy against CD19: what type of haematological malignancy does it target?
ALL, some non-hodgkin lymphoma?
73
7. Ankylosing spondylitis – they’ve tried NSAID and TNF inhibitor, what else can you target?
IL17
74
9. 45yo woman with autoimmune diseases, low IgM, IgA and IgE; full blood count is normal?
CVID
75
12. Which immunoglobulin is found in mucosa?
IgA
76
3. Immunodeficiency with common gamma chain problem?
X-linked SCID
77
4. A woman is a donor for kidney to a child, what is the max number of HLA mismatches possible?
6
78
6. Someone with aphthous ulcers, conjunctivitis, diarrhoea & abdo pain
Crohn's disease
79
8. Which type of cell does Rituximab target?
Mature B cells
80
9. cANCA positive man with glomerulonephritis and lung changes, what does he have?
Granulomatosis with polyangitis
81
Antibody for Graves
Stimulatory anti-TSH receptor
82
2. Nivolumab is a PD1 inhibitor, what cells does it target?
T cells
83
3. Woman with periorbital purple rash (heliotrope) and rash on knees, which enzyme is elevated?
Creatinine kinase (dermatomyositis)
84
4. What Type Hypersensitivity causes serum sickness?
Type 3
85
5. What is the effect of the gene mutation in familial Mediterranean fever?
Increased IL-1 production
86
6. Mechanism of hyperacute allograft rejection
preformed antibodies against HLA or ABO
87
1. Which of the following are most often used for prophylaxis against allograft rejection?
a. Mycophenolate mofetil, prednisolone, tacrolimus
88
3. Which of the following can be used to treat rheumatoid arthritis?
a. Adalimumab: TNFalpha
89
2. What cell in the body binds to MHC1?
NK cells
90
5. Man has intermittent mouth & tongue swelling for the past 2 years, which is unresponsive to over-the-counter anti-histamines, is on aspirin and ACE inhibitor. What is the likely cause?
Drug induced reaction

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